Pukerua Bay COVID-19 support
The Pukerua Bay Hub and Pukerua Bay Residents Association are working together to put neighbours in touch with each other so we can support each other during the COVID-19 pandemic.
We're looking for people who can provide practical help to others.
We are also looking for street champions. Those are people who can be contact points for their neighbours. If we have one or two in every street (more in Rawhiti Road or Sea Vista Drive), we can cover the whole village.
Collecting this information is just the start. More to come...
Name (first and family)
Please include the number so we can map the positions of helpers
Preferably your cell phone number (if you have one) for text communication
How can you help?
This is an initial list, and it is not exhaustive. We ask that you only choose things you would be willing to do, although we would understand your circumstances may change.
Check in over the phone with people who may need support
Help a person with practical support (e.g. groceries, collecting medication, posting mail, care packages/donations, etc)
Be a street champion on your street (ensuring there is a coordinated local response)
Are you happy for us to share your details with someone who needs help?
Information storage permission
I agree that personal data relating to me which has been obtained by the Pukerua Bay Hub and Residents Association (PBRA), including the personal data given by me on this form, may be held and processed either on computer or in manual records and may be disclosed to Hub and PBRA organisers and used by them for any purpose relating to my voluntary work
A copy of your responses will be emailed to the address you provided.
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Terms of Service